Over the past 13 years, intensive care has transformed from a variably-practiced specialty with abysmal mortality rates to a highly-protocolized system of care “bundles” to ensure standardized treatment delivery and improved outcomes. Effectively-conducted ICU care can truly save lives but requires training to understand the principles and practices of ICU medicine. Subspecialty expertise is not mandatory, and in fact, many ICU practitioners are broadly-trained primary care physicians. Each of you will obtain personalized one-on-one lectures on the most important ICU topics during your rotation. What follows is a list of essential readings compiled to include the most resident-friendly or particularly foundational articles (some of these have been printed for you). If you devote 3-4 hours to read the articles and check out the websites/videos, you will gain an excellent foundation prior to the start of your rotations.

  1. Introduction/Overview to Rotation (dropbox links must be accessed at home):
    1. Official Rotation Introduction: http://db.tt/d2WBOXPz
    2. Resident-to-Resident Overview: http://db.tt/XCIeTPqs

  1. ICU Care: Why Protocols?
    1. 2007 New Yorker, “The Checklist” by Atul Gawande: www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande?printable=true

  1. Septic Shock and Steroids:
    1. 2000: Original EGDT Article (fyi: intensive insulin/xigris now irrelevant): http://www.nejm.org/doi/pdf/10.1056/NEJMoa010307
    2. 2012: Update from Surviving Sepsis Campaign: http://www.survivingsepsis.org/GUIDELINES/Pages/default.aspx
http://www.sccm.org/Documents/SSC-Guidelines.pdf
  1. 2009: Steroids – yay or nay? http://jama.ama-assn.org/content/301/22/2362.full.pdf

  1. Arterial Blood Gas
    1. Quiz: http://vectors.cx/med/apps/index.html

  1. Ventilators (Basic and ARDS), BiPAP, and ABCDE
    1. 2001: Tobin’s Review Article: http://www.nejm.org/doi/pdf/10.1056/NEJM200106283442606
    2. 2000: Original ARDSNet Article: http://www.nejm.org/doi/pdf/10.1056/NEJM200005043421801
    3. 2012: Berlin update ARDS (read JAMA and vent card, read last article only if curious):
    4. http://jama.jamanetwork.com/article.aspx?articleid=1160659
    5. http://www.ardsnet.org/system/files/Ventilator%20Protocol%20Card.pdf
      1. http://pulmccm.org/2012/ards-review/consensus-panel-announces-new-definition-severity-classes-for-ards-jama/
      2. 2010: NMB in severe ARDS: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1005372
      3. 2008: BiPAP in COPD http://chestjournal.chestpubs.org/content/133/3/756.full.pdf+html
      4. 2012: ABCDE = Awakening & Breathing Coordination/Delirium Monitoring/Exercise & Early Mobility:
        1. http://online.wsj.com/article/SB10001424052748704081604576144321242020948.html
        2. http://www.mc.vanderbilt.edu/icudelirium/
  2. ACLS/Code Blue
    1. 2007 key JAMA article prioritizing compressions “Hands-Only CPR”: http://jama.ama-assn.org/content/299/10/1158.full.pdf+html
    2. 2010 Guidelines, 1st 7 pages are most useful: http://circ.ahajournals.org/content/122/18_suppl_3/S640.full.pdf
    3. Family Presence during Code Blues: http://ajcc.aacnjournals.org/content/14/6/494.full.pdf+html
    4. Therapeutic Hypothermia: Brief Resident-Directed Overview: http://blogs.nejm.org/now/index.php/therapeutic-hypothermia/2010/09/24/
    5. Therapeutic Hypothermia: 2010: Helpful Case Vignette: http://www.nejm.org/doi/pdf/10.1056/NEJMct1002402



  1. Cardiac
    1. 2012 NEJM Overview http://www.nejm.org/doi/full/10.1056/NEJMra1112570
    2. 2010 NSTE ACS Mgmt: http://www.ccjm.org/content/77/2/101.full.pdf+html
    3. 2012 PCI vs CABG update: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1110717
    4. 2001 AFib: http://www.nejm.org/doi/pdf/10.1056/NEJM200104053441407
    5. 2006 SVT Vignette: http://www.nejm.org/doi/pdf/10.1056/NEJMcp051145
    6. 2003 CHF Overview: http://www.nejm.org/doi/pdf/10.1056/NEJMra021498

  1. GI
    1. 2010: Overview of UGIB http://www.ccjm.org/content/77/2/131.full.pdf+html
    2. 2009: Severe Acute Pancreatitis http://chestjournal.chestpubs.org/content/136/5/1413.full.pdf+html

  1. Common ICU Procedures (feel free to google or youtube other ones)
    1. 2010 Ultrasound-Guided Internal Jugular insertion: http://www.nejm.org/doi/full/10.1056/NEJMvcm0810156
      1. 2007 Subclavian insertion http://www.nejm.org/doi/full/10.1056/NEJMvcm074357
      2. 2006 A-line placement http://www.nejm.org/doi/full/10.1056/NEJMvcm044149

  1. Palliative Care, End of Life, and Bioethics
    1. 2010 New Yorker, “Letting Go” by Atul Gawande http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande
    2. Family Meetings: http://www.uptodate.com/contents/communication-in-the-icu-holding-a-family-meeting
    3. Ethical Issues in ICU: http://www.uptodate.com/contents/ethics-in-the-intensive-care-unit-withholding-and-withdrawing-life-support
    4. On CCHS computers, you can find an ethics folder. The following link will work from any hospital computer with wonderful reports that can be helpful: \\Rmcserver\MedSrv\Ethics\2.0 - Guidelines for Common Issues in Clinical Ethics

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This page has been edited 2 times. The last modification was made by - dlongstroth dlongstroth on May 15, 2013 9:53 pm